Yudofsky S C
Gen Hosp Psychiatry. 1981 Dec;3(4):292-6. doi: 10.1016/0163-8343(81)90035-9.
This paper documents the recent dramatic shift towards the delivery of psychiatric services in the general hospital setting and outlines the increasing number of special indications for electroconvulsive therapy (ECT). These include: delusional depression; depressions which are not responsive to antidepressants; affective illness in geriatric populations, depression, mania or schizophrenia in patients who cannot tolerate medication side effects, and drug-refractory Parkinson's disease. Such technological advances as nondominant unilateral placement of electrodes, brief pulse electrical stimulation, and simultaneous ictal monitoring of EEG and EKG have increased the safety while reducing the side effects of the procedure. In that comparative studies show ECT to have safety and efficacy superior to antidepressant agents in the treatment of severe depressive illness, the author encourages physicians to consider this treatment which is becoming increasingly available through our general hospital services.
本文记录了近期在综合医院环境中提供精神科服务的显著转变，并概述了电休克治疗（ECT）越来越多的特殊适应症。这些适应症包括：妄想性抑郁症；对抗抑郁药无反应的抑郁症；老年人群中的情感性疾病、无法耐受药物副作用的患者的抑郁症、躁狂症或精神分裂症，以及药物难治性帕金森病。诸如非优势侧单侧电极放置、短脉冲电刺激以及脑电图和心电图同步发作期监测等技术进步提高了该治疗的安全性，同时减少了副作用。鉴于比较研究表明ECT在治疗重度抑郁症方面具有优于抗抑郁药的安全性和疗效，作者鼓励医生考虑这种通过综合医院服务越来越容易获得的治疗方法。
